[Symptoms] Waking up extremely anxious

[riancharles]

Hi Everyone,

This is my first post here. I've been using CPAP for almost 11 months now, and am able to keep the mask on all night long (typically 8-9 hours). I know it's just a small piece of the puzzle, but my AHI with the Resmed Airsense 11 has averaged 1.74 since I started using the machine. My pressures are set to 5-10 and the EPR is set to 1. Pressures were a bit higher before, but I was swallowing too much air and having more unpleasant gas issues that haven't totally gone away with the lower pressure, but definitely better. 

I have existing anxiety that I treat with medication and therapy, but I have been experiencing extreme anxiety upon waking up in the morning that seems to have gotten exponentially worse since starting CPAP. It is becoming very unbearable. It is a strong bodily sensation of anxiety that is very difficult to manage. 

I have asked my sleep doc about it and shared some OSCAR charts with them, but they said since my AHI is well below 5/hour, they didn't have any advice. I also asked them about RERAs and Flow Limitation, but they didn't have much to say about it.

I'm desperate for some help, and am wondering if I am missing something as far as CPAP settings or continuing apnea issues (or RERAs, flow limitation etc) that could be causing it. Can you please take a look?

I have attached a couple of screenshots. 

       

Thanks in advance!

[Deborah K.]

I see a few changes that should help you sleep better.

Since you have been at this a long while, turn off ramp.  You no longer need it.

Your pressure settings are not meeting your needs.  I suggest you set your range to 7 to 12.  You are over 9 on your median pressure, but we will slowly increase to that.  Try the 12 as your top pressure, then you'll see if you still have aerophagia.  If so, we can try lowering it a little. With all the other changes you might just feel fine with the changes.

Your flow limits are high, so you need to turn EPR on full-time, set at 3.  This will make your breathing more comfortable and will lower your flow limits, an important thing to do.

Your Oscar chart is good except it does not show your flow limits below the leaks.  We need to be able to read to the very bottom of the flow limits.  Making that change will make your charts perfect.

Again, welcome, and good luck with your therapy!  

[riancharles]

Thank so much for your recommendations, Deborah!